Abstract
BackgroundThis study aimed to determine to what extent an aging population and shift to chronic illness has contributed to emergency admissions at a tertiary care hospital over ten years.MethodsThis was a retrospective observational study performed using a database of all emergency admissions from the Emergency Department (ED) at a single tertiary hospital in Singapore during a ten-year period (January 1st, 2008 to December 31st, 2017). Emergency admissions were defined as ED visits with inpatient admission as the disposition. This study analyzed the trends of demographics, pre-existing comorbidities, chronic conditions or ambulatory care sensitive conditions (ACSC) of all patients who underwent emergency admissions in Singapore General Hospital.ResultsA total of 446,484 emergency records were included. For elderly patients, the proportions of them had pre-existing multimorbidity at the time of undergoing emergency admissions were found to be lower at the end the 10-year study period relative to the beginning of the study period. The proportions of emergency admissions whose ED primary diagnoses were categorized as chronic conditions and certain chronic ACSC including chronic obstructive pulmonary disease, congestive heart failure, diabetes complications, and epilepsy also decreased for elderly patients over the 10-year study period.ConclusionsIn Singapore, despite a rapidly aging population, there have been surprisingly lower proportions of chronic conditions, pre-existing comorbidities, and chronic ACSC among the elderly emergency admissions. This is possibly consistent with an overall improved management of the chronic conditions among the elderly population. Future studies should include similar studies at the national level and comparison with other healthcare settings in different countries.
Highlights
This study aimed to determine to what extent an aging population and shift to chronic illness has contributed to emergency admissions at a tertiary care hospital over ten years
The overall objective of this study is to determine to what extent the aging population and chronic conditions have contributed to the volume of elderly emergency admissions
This study focused on the nine chronic ambulatory care sensitive conditions (ACSC) (Table S1)
Summary
This study aimed to determine to what extent an aging population and shift to chronic illness has contributed to emergency admissions at a tertiary care hospital over ten years. The pace of population aging is increasing, both in developed and developing countries [1]. Singapore is challenged by rising demand for emergency care, evidenced by a 47% increase in annual total visits to public sector emergency departments (EDs) from 2005 to 2015 [5]. Emergency admissions, defined as patients visiting ED admitted for inpatient. When elderly patients (age 65 and above) visit the ED, they are more likely to have emergency admissions compared to younger patients [6, 7]. Elderly patients are more likely to have a longer hospital stay, higher healthcare costs, and higher overall mortality rate after emergency admissions [8,9,10]
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